The Power of Negative Thinking - The Nocebo Effect

[RedOnce]

The Nocebo Effect

Harvard Magazine, Inc. May-June 2005

If people expect to feel better from a pill or medical treatment, they just might, even if the pill is made of sugar or the treatment is a sham. This kind of response is so well established that researchers regularly use placebos—inert or dummy drugs, classically described as “sugar pills”—in clinical trials to help gauge how much of an active medication’s effectiveness comes from the drug itself.

But placebos have a flip side: some people claim to feel worse after taking the inert chemicals. They complain of headaches, fatigue, insomnia, stomach­aches, nausea, dizziness, weakness, and other symptoms—side effects they claim weren’t there, pre-placebo. These ailments are not only real, but can be disabling, and about a quarter of those taking placebos report them, says professor of psychiatry Arthur Barsky, who studies medically unexplained symptoms.

The JAMA paper cites other factors. A patient who expects to suffer painful symptoms is more likely to. Depressed patients tend to feel bodily distress. Women, who report disturbing initial symptoms more often than men, are also more likely to report nocebo effects. Patients with a history of side effects can become conditioned to develop them again—and not only because of drugs. In one study, a third of chemotherapy patients felt extremely nauseous upon entering a room painted the same color as the one where they got their chemo treatments.

External factors come into play as well. A drug’s reputation can make people wary. Many patients, for example, are aware of allergies to penicillin—up to 10 percent of those hospitalized report a penicillin allergy, according to Barsky’s paper. But in a carefully supervised and monitored study of such patients, 97 percent of them actually had no reaction when they were administered oral penicillin. Even a pill’s size, shape, and color can make a difference. Studies have shown that red, orange, and yellow pills are associated with stimulants; blue and green pills tend to make people sleepy.

http://www.harvardmagazine.com/on-line/050572.html

[bemildred]

1. Gee, it's almost like your mind an body are connected somehow ...

:hi:

[RedOnce]

2. Almost...amazing, isn't it?

[bemildred]

3. It's amazing they have to do a study to know this.

Although there is something to be said for quantifying the effect, so maybe there is a point to it in that sense.

[Salviati]

4. Not surprising but...

"up to 10 percent of those hospitalized report a penicillin allergy, according to Barsky’s paper. But in a carefully supervised and monitored study of such patients, 97 percent of them actually had no reaction when they were administered oral penicillin"

I may very well be one of those people. I was given penicillin once, as an infant, and had a reaction to it. I've never had penicillin since. Am I still alergic to it? Who knows, I've always been able to get other antibiotics, so it's never been an issue, but the alergy is still in my file, and I still mention it when asked. I'd imagine that a good portion of that 9.7% of people with a reported penicillin allergy are just like me.

[RedOnce]

5. Brainpower The Best Medicine?

CBS News - March 25, 2006

Your medicine really could work better if your doctor talks it up before handing over the prescription. Research is showing the power of expectations, that they have physical — not just psychological — effects on your health. Scientists can measure the resulting changes in the brain, from the release of natural painkilling chemicals to alterations in how neurons fire.

Among the most provocative findings: New research suggests that once Alzheimer's disease robs someone of the ability to expect that a proven painkiller will help them, it doesn't work nearly as well. It's a new spin on the so-called placebo effect — and it begs the question of how to harness this power and thus enhance treatment benefits for patients. "Your expectations can have profound impacts on your brain and your health," says Columbia University neuroscientist Tor Wager.

Doctors have long thought the placebo effect was psychological. {b]Now scientists are amassing the first direct evidence that the placebo effect actually is physical, and that expecting benefit can trigger the same neurological pathways of healing as real medication does.

"Our brain really is on drugs when we get a placebo," says co-researcher Christian Stohler, now at the University of Maryland. More remarkable, some especially strong placebo responders suggest "many brains can actually stimulate that (pain-relief) system more." ...To further prove the power of belief, Benedetti hooked pain patients to a computerized morphine injection system. Sometimes the computer administered a dose without them knowing it; sometimes a nurse pretended to give it. The morphine was up to 50 percent more effective when patients knew it was coming.

http://www.cbsnews.com/stories/2005/11/29/health/main1081624.shtml